Presumed COVID-19-associated conjunctivitis

Abstract

Objective: To report the case of a patient with a picture of “presumed” conjunctivitis associated with COVID-19 disease.
Clinical case: 29-year-old female patient consulting virtually due to unspecific ocular disturbances and dryness who referred that she had experienced ocular pain and redness in the left eye one week before while isolated because of positive PCR test results for COVID-19, with no other manifestation. During tele-consultation the predominant symptom was ocular dryness, with no other data indicative of alarm or urgency. She was prescribed lubricant eye drops and a face-to-face appointment in the office was scheduled in seven days once the patient had obtained release from isolation according to epidemiologic protocols.
During the face-to-face visit she referred sandy sensation in both eyes and a mild conjunctival hyperemia was evidenced as well as moderate papillary reaction. She was prescribed a fixed-dose combination of antibiotic and corticosteroid eye drops and a new control visit was scheduled in 10 days. On the second face-to-face visit though symptoms had subsided almost completely biomicroscopy revealed shortened TBUT and therefore she was indicated to continue use of ocular lubricants.
After 4 months, on a control visit, the patient was asymptomatic and reported she was using ocular lubricants occasionally.
Conclusion: Conjunctival inflammation may be a sign suggesting the presence of COVID 19, however, it is difficult to have confirmatory diagnosis during the visit. This is why we stress the importance of maintaining a high suspicion index and to have a previous virtual consultation when patients refer the symptoms described here, and to always wear the adequate personal protective equipment in the subsequent ophthalmic face-to-face visit.